1. Field of Invention
This invention relates to surgical devices and methods for dissection and removal of blood vessels from a patients body. In particular this invention relates to endoscopic vessel harvesting devices and methods.
2. Description of Related Art
Endoscopic harvesting of vessels is well known in the surgical field and has been the subject of a great deal of recent technological advancement. Typically, the harvesting of vessels is performed so that the vessels can be then used for procedures such as Cardio Artery Bypass Grafting (CABG). In this procedure the saphenous veins of the legs are harvested for subsequent use in the CABG surgery.
Known methods and devices for performing vessel harvesting are discussed in detail in U.S. Pat. No. 5,667,480 issued Sep. 16, 1997 and U.S. Pat. No. 5,722,934 issued Mar. 3, 1998, both issued to Knight, et al, both of which are incorporated herein by their reference.
In the traditional endoscopic harvesting devices shown in prior art FIG. 1, there is provided a hollow shaft 12 connected to a concave headpiece 16 located at the distal end of the shaft which provides a workspace 18. An endoscope 5 is typically inserted in the shaft so that the surgeon may view workspace. The leading edge of the headpiece 16 is used for dissecting the vessel from the surrounding tissue. The device may also have guides located on the underside of the device which allow for the entry of other devices such as dissectors, ligation tools, and cutting tools, into the workspace.
The traditional method for removal of a vessel section is shown in FIGS. 2 and 3. Initially an incision 3 is made and the vessel 7 is located. Then, the vessel is dissected from the surrounding tissue using the leading edge of the headpiece 16 of the device to separate the tissue from the vessel 7. At this time there is sufficient space created around the vessel 7 so that other instruments can be inserted into the incision 3 via the guides located on the underside of the device. These instruments include ligation tools for securing side branch vessels 9, vessel dissectors for performing a more complete dissection of the vessel 7 which is to be removed, and laproscopic scissors for the transection of both the side branch vessels 9 and the vessel 7 which is to be removed.
Of the known techniques for harvesting vessels and devices used for such procedures, as in the case in the above described procedure and device, the blunt dissection is performed using the headpiece 16 of the device, and then any dissection to be performed under the device must be performed using other tools which must be inserted into the patient following the original incision 3. Upon the discovery of a side branch vessel 9 still further tools must be inserted into the incision 3 for performing the ligation and transection function.
The tool exchanges of instruments, and in fact the instruments themselves complicate the procedure. They require a great deal of skill to master and no matter the skill of the person performing the procedure, the process requires a great deal of time to perform.
Accordingly, it is an object of the present invention to overcome the short comings of the prior art by providing a device which can limit the number of tools required to perform the removal of the vessel, decrease the number of tool exchanges necessary to perform the removal, and increase the efficiency and ease of operation of the entire procedure.